Muevete (Move) USA


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Muevete (Move) USA
Angie Millan, RN, MSN, FAAN
Principal Investigator
National Association of Hispanic Nurses

Mano y Corazón Binational Conference of Multicultural Health Care Solutions, El Paso, Texas, September 27-28, 2013

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  • It is named after the first lady Michele Obama’s “Let’s Move” initiative.
  • Today, more than 23 million children and teens in the United States, Nearly 1 in 3 young people are over weight or obese Obesity is a nationwide epidemic, a leading and fastest-growing cause of disease and death in the USA. It is a medical condition and an imbalance in which excess body fat has accumulated in your body leading to increased health problems. If this trend continues this generation of young people could be the first in U. S. history to live sicker and die younger than their parent’s generation. Estimated $190.0 billion annual cost of obesity-related illness of 21% of annual medical spending is on obesity
  • Lets look at the current trends of Hispanic Children. Latino children comprise 22% of all U.S. youth and represent the largest, youngest, and fastest-growing minority group in the nation. 38.2% of Latino children ages 2-19 are overweight or obese Obesity may lead to metabolic syndrome, a combination of medical disorders which includes, diabetes mellitus type 2, high blood pressure, high blood cholesterol, high triglyceride levels. It also causes sleep apnea and certain type of cancers, osteoarthritis. These debilitating conditions that in the past mostly affected adults. These factors make it an urgent priority to address Latino childhood obesity. As it continues to contribute to the gap in Hispanic health disparities in to the future.
  • We know that Obesity is can be prevented. I want to discuss 2 reports that the IOM has put out on preventing childhood obesity. 1. Preventing childhood obesity: Health in the balance and Progress in preventing childhood obesity: How do we measure up? What are we doing? Need to understands the this issue is has complex interactions across social, environmental, and policy contexts that have created an adverse environment for maintaining healthy weight. NAHN need to recognized that prevention of childhood obesity is a National priority and we all need to get involve, especially nurses
  • The message is that Obesity is very complex issue but is conquerable. In summary, we know that the causes of childhood obesity are multi-factorial. Genetics, social factors, race, ethnicity, media, marketing and physical environments all influence child obesity. Targeting one factor may not make a significant impact on this growing problem therefore NAHN targeted 2 main factors of healthy eating and exercise. Because we know generally caused by a lack of physical activity and unhealthy eating.
  • The institute of Medicine release a report that outlines comprehensive strategies for addressing the obesity epidemic and calls on leaders in all sectors to go into action using 5 goals. 1. Integrate Physical activity everyday 2. Eat well (healthy food beverage options) 3. Make healthy foods available every where 4. Strengthen the school as the heart of health 5. Activate employers and health care professionals
  • In 2011, NAHN piloted the Muevete USA project to raise awareness of childhood obesity in our communities To encourage Hispanic Youth to make healthy lifestyle changes. The pilot was implemented in 5 chapters and it was proven to be a success and found to be a great need in our communities.
  • In 2012 , to implement the project in 15 locations throughout the United States. Target population is School age children and their parents. In addition, what is unique this year is that we will include the entire families in the programs, not just the children. As we know that the parents are the one’s that make the food choices for the family (look up article to quote here) A second feature is that each chapter that is participating in the project will need to sustain the program, so it will not just take place this year, but the charge is that they will continue it year after year. They will do this by securing partners who will provide funding and resources to fund the program year after year.
  • The National Association of Hispanic Nurses has 48 chapters through the USA, We are currently implementing the project in 15 different locations throughout the United States this year, the chapters are in the following cities: San Francisco, Orange County, Los Angeles, Denver, Valle de Sol, El Paso, Bridgeport, Chicago, Philly, New York, New Jersey, DC, and Atlanta. 2013 we have 20 Chapters currently.
  • My Plate (CDC)- How to use it, cut out different pictures of food and had them show examples of a health choices. Food Labels- How to read food labels-Photo copy labels from unhealthy and healthy foods. For example a popular snack in LA is Flalmin hot Cheetos and Takis so we used it to show the children what it has. (1oz, 160 calories, 11gms fat, 10% NA, but usually a bag is 2 to 3 times a bag) Healthy Snacks-Discuss other choices, allow them to taste different fruits and vegetables, some chapters made snacks or went shopping to the market together. Physical Activity –Difference between physical activity and exercise Empowering children by teach them how to do Goal Setting: about eating healthy and be physically active/ make it fun
  • Provided all instructors with standardize lesson plans that have the following (READ SLIDE) For example- Physical Activity and Exercise lesson plan, we start out by explaining the difference: Physical activity is a movement, we do throughout the day: house work, gardening, walking, climbing stairs are examples Versus exercise is a specific form of physical activity- planned, purposeful performed as a fitness, swimming, cycling, running sports, PE class. We make sure they understand the difference, that it is important to be physically active all day. Then it is followed by some type of fun physical activity.
  • Locations: Churches in communities, charter schools, after school programs, Sessions: Weekly, weekends, (one hour sessions) one day weekend Incentives: raffle, gift certificates, healthy snacks, bike raffle, t-shirt Work with community partners: What is key or unique to this project is that each chapter had the flexibility to implement the program to meet the needs of their community.
  • Read slide
  • 2012 results
  • There were a total of 725 participants in the project. Of that total, 640 (88%) were youth and 85 (12%) were adults parents/guardians/caregivers of the youth. The majority of the participants were of Hispanic background (694 or 96%); non-Hispanic White (6 or .8%) and African American (10 or 1.3%). There were 15 participants of the other racial/ethnic groups that include Filipino, Alaskan Native, and Pacific Islander (15 or 2%). Of the chapters that did report gender and age, there were slightly more girls (54%) than boys (46%). Of the youth, 29% were in the age group 9-12 years of age; however, there was a great variation in the youth age. Relative to the adults, 92% were in the age group 30-45 years of age. Of the chapters that report the educational status of the adults that participated, approximately 75% did not have a high school education.
  • This did indicate some level of effectiveness relative to combating childhood obesity as the adult participants are more readily able to institute these healthy lifestyle strategies in home. These included participants arriving at different times during the sessions; various literacy levels and missed sessions. Future Muevete USA™ programs will focus their aims on this group and will strategize to best methods in getting this group to participate in sessions knowing what some barriers have been.
  • Through our year-long effort with Muevete USA™ , several vital lessons have been learned of importance for the future efforts. They include: Although an effort was made by all chapters to include the parent/caregiver/guardian of the youth involved, it proved very challenging for a number of reasons the least being work and family demands. Attendance was varied. In the future incentives may be key, particularly incentives that are critical to the participants, such as gift card to a local grocery store. In addition, it may be more worthwhile to have all five lessons done in one day and then scheduling follow-up home visits or telephone calls. This allow for opportunities to partner with academic nursing schools as they may be able to make visits as part of their clinical requirement. In the future, rather than a written test or quiz, NAHN will construct a test/quiz that uses matching visuals cues when prompted to answer a facilitator’s questions. In the future, NAHN will provide a database for consistency in the entry of data by individuals chapters. This will create more of an opportunity to drill down into the numbers so that the analysis can continue to provide where our efforts in combating childhood obesity need to be focused
  • Dear Muevete USA, Thank you very, very much for teaching us how to eat right. Thanks to you guys, I am more aware of my health. I learned that we need to eat lots of healthy foods. I’m already overweight, but now I can eat more healthy and exercise for about 30 min. a day. You guys were so, so helpful to me, my classmates and my family. It was fun learning experience, you brought in prizes, very fun. You were also able to get us some healthy snacks. You guys also taught us different exercises. But I’m sorry for the way I acted, I just got carried away. I was so excited to start my healthy living. Thanks for coming. Sincerely, Freedom All
  • Muevete (Move) USA

    1. 1. Mano y Coraz’on Binational Conference Of Multicultural Health Care Solutions Angie Millan, RN, MSN, FAAN Principal Investigator September 27, 2013
    2. 2.  22% of all US youth & represent largest, youngest, and fastest-growing minority group  38.2% ages 2-19 years are overweight or obese  Obesity carried into adulthood is associated with DM, HTN, asthma, sleep apnea and some types of cancer
    3. 3. Two IOM reports on preventing childhood obesity: Preventing childhood obesity: Health in the balance & Progress in preventing childhood obesity: How do we measure up? Recognize that prevention of childhood obesity is a national priority The need to understand the complex interactions across social, environmental, and policy contexts that have created an adverse environment for maintaining a healthy weight
    4. 4.  Muevete (Move) USATM was designed/executed by NAHN as a pilot in 2011 and fully launched in 2012  To raise awareness of childhood obesity issue  Encourage Hispanic youth to make and more importantly sustain healthy lifestyle changes
    5. 5. In 2012 NAHN deployed Muevete (Move) USATM in 15 locations. Unique this year is including entire families in the program.
    6. 6. Los Angeles San Francisco Bridgeport Chicago Atlanta Corpus Christi New York Brownsville D.C. New Jersey El Paso Valle de Sol Orange County Denver San Diego
    7. 7.  MyPlate  Food Labels  Healthy Snacks  Physical Activity and Exercise  Empowering Kids to make Healthy Choices
    8. 8.  Learning Objectives  Recommended Readings  Suggested classroom activities  Pre and Post Quiz  Demographic information
    9. 9.  Chapters target families in location of their choice  Recommend one hour sessions, can be done all in one day  Incentives suggested to engage entire family  Work with community partners
    10. 10.  Chapters want to be involved in issue of childhood obesity  Chapters do not want to exclude anyone  Chapters have developed very unique and important partnerships with schools, CBO’s, faith-based organizations, etc.  Some chapters have found transportation to be an issue
    11. 11. Creative incentives are necessary Involve nursing students!! Keep messages short and simple
    12. 12. Chapter Youth Adults Total Atlanta, GA 10 10 Bridgeport, CT 15 12 27 Brownsville, TX 7 3 10 Chicago, IL 105 105 Corpus Christi, TX 40 14 54 Colorado 12 12 El Paso, TX 10 7 17 Los Angeles, CA 148 148 New Jersey 17 12 29 New York 56 56 Orange County, CA 28 12 40 San Diego, CA 27 13 40 San Francisco, CA 78 78 Valle de Sol, AZ 27 27 Washington, DC 60 12 72 TOTAL 640 (88%) 85 (12%) 725
    13. 13. Hispanics 694 (96%) White 6 (.8%) African American 10 (1.3%) Other 15 (2%) Total 725
    14. 14.  Total of 174 Nurse instructors trained from fifteen chapters
    15. 15.  Did not have a robust number of adults/caregivers/guardians attending the lessons, this group made significant gains in knowledge about healthy lifestyles, when comparing the pre and post-tests results (69% pre-test vs. 76% post-test).  Youth pre-test and post-test scores were lower, but also showed significant improvement (35% pre-test vs. 57% post-test).
    16. 16.  1.- Challenging to include Parent/Caregivers guardian of all youths.  2.- Uneven participation in the pre and post-test and the limited literacy levels of participants.  3.- Not all chapters followed the same method when collecting the data.
    17. 17. QuestionsQuestions
    18. 18. Social Media (Please click on the links below):